-----BEGIN PRIVACY-ENHANCED MESSAGE----- Proc-Type: 2001,MIC-CLEAR Originator-Name: webmaster@www.sec.gov Originator-Key-Asymmetric: MFgwCgYEVQgBAQICAf8DSgAwRwJAW2sNKK9AVtBzYZmr6aGjlWyK3XmZv3dTINen TWSM7vrzLADbmYQaionwg5sDW3P6oaM5D3tdezXMm7z1T+B+twIDAQAB MIC-Info: RSA-MD5,RSA, KkHVuDhTyCvGETOshln8MM7ljDgpBoMl3DVL13Xt8nyB+Lpld3ryo9gjNz8+G1Np kDoYj3zAQz6A3QIBiBFQbg== 0000944209-97-001331.txt : 19971006 0000944209-97-001331.hdr.sgml : 19971006 ACCESSION NUMBER: 0000944209-97-001331 CONFORMED SUBMISSION TYPE: 3 PUBLIC DOCUMENT COUNT: 1 CONFORMED PERIOD OF REPORT: 19971001 FILED AS OF DATE: 19971003 SROS: NASD SUBJECT COMPANY: COMPANY DATA: COMPANY CONFORMED NAME: OSI SYSTEMS INC CENTRAL INDEX KEY: 0001039065 STANDARD INDUSTRIAL CLASSIFICATION: SEMICONDUCTORS & RELATED DEVICES [3674] IRS NUMBER: 330238801 STATE OF INCORPORATION: CA FISCAL YEAR END: 0630 FILING VALUES: FORM TYPE: 3 SEC ACT: SEC FILE NUMBER: 000-23125 FILM NUMBER: 97690705 BUSINESS ADDRESS: STREET 1: 12525 CHADRON AVE CITY: HAWTHORNE STATE: CA ZIP: 90250 BUSINESS PHONE: 3109780516 MAIL ADDRESS: STREET 1: 12525 CHADRON AVENUE CITY: HAWTHORNE STATE: CA ZIP: 90250 COMPANY DATA: COMPANY CONFORMED NAME: HICKMAN THOMAS K CENTRAL INDEX KEY: 0001047064 STANDARD INDUSTRIAL CLASSIFICATION: [] OFFICER FILING VALUES: FORM TYPE: 3 BUSINESS ADDRESS: STREET 1: C/O OSI SYSTEMS INC STREET 2: 12525 CHADRON AVE CITY: HAWTHORNE STATE: CA ZIP: 70250 MAIL ADDRESS: STREET 2: 12525 CHADRON AVE CITY: HAWTHORNE STATE: CA ZIP: 90250 3 1 FORM 3 +--------+ | FORM 3 | U.S. SECURITIES AND EXCHANGE COMMISSION +--------+ WASHINGTON, D.C. 20549 INITIAL STATEMENT OF BENEFICIAL OWNERSHIP OF SECURITIES Filed pursuant to Section 16(a) of the Securities Exchange Act of 1934, Section 17(a) of the Public Utility Holding Company Act of 1935 or Section 30(f) of the Investment Company Act of 1940 - -------------------------------------------------------------------------------- 1. Name and Address of Reporting Person Hickman Thomas K. ---------------------------------------------------------------------------- (Last) (First) (Middle) 12525 Chadron Avenue ---------------------------------------------------------------------------- (Street) Hawthorne California 90250 ---------------------------------------------------------------------------- (City) (State) (Zip) 2. Date of Event Requiring Statement (Month/Day/Year) 10/1/97 -------------- 3. IRS or Social Security Number of Reporting Person (Voluntary) 000-00-0000 -------------- 4. Issuer Name and Ticker or Trading Symbol OSIS ----------------------------------- 5. Relationship of Reporting Person to Issuer (Check all applicable) [ ] Director [X] Officer [ ] 10% Owner [ ] Other (give title below) (specify below) Managing Director, OSI Singapore And OSI Malaysia ---------------------------------------------------------------------------- 6. If Amendment, Date of Original (Month/Day/Year) ---------------------------- TABLE I--NON-DERIVATIVE SECURITIES BENEFICIALLY OWNED
- -------------------------------------------------------------------------------- 1. Title 2. Amount of 3. Ownership Form: 4. Nature of of Securities Bene- Direct (D) or Indirect Bene- Security ficially Owned Indirect (I) ficial Ownership (Instr. 4) (Instr. 4) (Instr. 5) (Instr. 5) - -------------------------------------------------------------------------------- Common Stock, no par value 27,228* D - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - -------------------------------------------------------------------------------- - --------------------------------------------------------------------------------
*Includes 15,187 shares issuable pursuant to fully vested options. Reminder: Report on a separate line for each class of securities beneficially owned directly or indirectly. (Print or Type Responses) FORM 3 (continued) TABLE II--DERIVATIVE SECURITIES BENEFICIALLY OWNED (e.g., puts, calls, warrants, options, convertible securities)
- ------------------------------------------------------------------------------------------------------------------------------------ 1. Title of Derivative 2. Date Exer- 3. Title and Amount of Securities 4. Conversion 5. Ownership 6. Nature of In- Security (Instr. 4) cisable and Underlying Derivative Security or Form of direct Bene- Expiration (Instr. 4) Exercise Derivative ficial Date Price Security: Ownership (Month/Day/ of Direct (D) (Instr. 5) Year) Derivative or In- ---------------------------------------------------- Security direct (I) Date Expira- Amount or (Instr. 5) Exer- tion Title Number of cisable Date Shares - ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock * 11/14/01 Common Stock 3,750 $ 2.83 D - ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock ** 5/31/02 Common Stock 6,000 $11.50 D - ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock *** 1/20/00 Common Stock 5,250 $ 2.00 D - ------------------------------------------------------------------------------------------------------------------------------------ Options to Purchase Common Stock **** 6/4/01 Common Stock 15,000 $ 2.50 D - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - ------------------------------------------------------------------------------------------------------------------------------------ - -----------------------------------------------------------------------------------------------------------------------------------
Explanation of Responses: *Fully vested **Vest over four-year period from grant date. ***75% vested. ****50% vested. *****Intentional misstatements or omissions of facts constitute Federal Criminal Violations. See 18 U.S.C. 1001 and 15 U.S.C. 78ff(a). Note: File three copies of this Form, one of which must be manually signed. If space provided is insufficient, See Instruction 6 for procedure. /s/ Thomas K. Hickman 9/30/97 ------------------------------- ----------------- **Signature of Reporting Person Date By: For: -----END PRIVACY-ENHANCED MESSAGE-----